Mayors award nomination form: City of Fort Collins

2009 Mayor's Award Nomination Form

The deadline for nominations is Friday, September 11, 2009. Nominees will be contacted and invited to attend an Awards Ceremony and Luncheon to be held on Thursday, October 8 from 11:30 - 1:00 at the Northside Aztlan Community Center (Ballroom 2) in Fort Collins. Award recipients will be announced at this time.

Please complete the following for all award categories. Fields in red are required.

Award Category:

	Dorothy Lasley Award (nominee must be disabled) Indicate disability of nominee:
	Employer of the Year
	Employee of the Year
	Service Provider of the Year
	Spirit of Fort Collins
	Volunteer of the year

Name of person/organization/business being nominated:

Mailing Address:

City:

State:

Zip Code:

Phone numbers:

home: work:

(at least one phone number is required)

Person and/or Group submitting nomination:

Mailing Address:

City:

State:

Zip Code:

Phone numbers:

home: work:

(at least one phone number is required)

E-mail:

Description: You may copy and paste your description of the nominee's qualifications from a plain text (no formatting such as bullet points, etc.) document, or you may type it in the box below. Briefly describe the contribution on which this nomination is based, including special projects initiated. Describe how the actions of the nominee have improved employment, accessibility, awareness, and/or the quality of life for persons with disabilities. For Dorothy Lasley Award, indicate how the nominee has exemplified the spirit of Ms. Lasley.